Gastrointestinal dysfunction in Chinese patients with fat-phobic and nonfat-phobic anorexia nervosa

2012 ◽  
Vol 49 (5) ◽  
pp. 678-695 ◽  
Author(s):  
Sing Lee ◽  
King Lam Ng ◽  
Kathleen P. S. Kwok ◽  
Jennifer J. Thomas ◽  
Anne E. Becker
Keyword(s):  
Anorexia Nervosa ◽  
Gastrointestinal Symptoms ◽  
Somatic Symptoms ◽  
Chinese Patients ◽  
Gastrointestinal Dysfunction ◽  
General Psychopathology ◽  
Gastrointestinal Complaints ◽  
Fat Phobia ◽  
The Relationship ◽  
Cross National

Although gastrointestinal and other somatic symptoms are common in patients with anorexia nervosa (AN), and a growing cross-national literature indicates that not all anorexic patients exhibit the core diagnostic symptom of fat phobia, the relationship between somatic symptoms and anorexic illness remains unclear. Our objective was to evaluate gastrointestinal dysfunction (GD) in Chinese patients with fat phobic (FP) and nonfat phobic (NFP) anorexia nervosa. A total of 113 FP- and 28 NFP-AN outpatients underwent standardized clinical assessment and completed a new 8-item GD scale and other psychopathological measures. A majority (79.4%) of AN patients reported at least some gastrointestinal complaints on the GD scale (Cronbach’s alpha = 0.78). FP-AN patients scored significantly higher than NFP-AN patients. The FP-AN with high GD group reported a higher level of specific and general psychopathology than the FP- and NFP-AN with low GD groups. Contrary to expectations, gastrointestinal symptoms were more common in FP-AN than NFP-AN patients. FP-AN with high GD was more severe than FP- and NFP-AN with low GD. The current fat phobic conceptualization of the anorexic illness may overlook its phenomenologic heterogeneity and reify a dichotomy that is inconsistent with patients’ varied experience of food restriction.

Relationship Between Control and the Intermediate Term Outcome of Anorexia Nervosa in Hong Kong

2005 ◽  
Vol 39 (3) ◽  
pp. 141-145 ◽  
Author(s):  
Sing Lee ◽  
Y.Y. Lydia Chan ◽  
Kathleen Kwok ◽  
L.K. George Hsu
Keyword(s):  
Anorexia Nervosa ◽  
Chinese Patients ◽  
Sense Of Control ◽  
Eating Disorder Inventory ◽  
Term Outcome ◽  
Cross Sectional ◽  
Positive Sense ◽  
Specific Sense ◽  
The Relationship ◽  
Negative Sense

Objective: To examine the relationship between control and the intermediate term outcome of Chinese patients with anorexia nervosa. Method: 88 patients who fulfilled the DSM-III-R criteria for typical (fat phobic, n = 63) and atypical (non-fat phobic, n = 25) anorexia nervosa were contacted 9 years after the onset of illness. They completed the Morgan-Russell Outcome Assessment Schedule, Shapiro Control Inventory, and Eating Disorder Inventory-I. Results: 62.2%, 32.4% and 5.4% of patients had good, intermediate, and poor outcome. Outcome was positively correlated with the overall general and specific sense of control, positive sense of control, and negatively with negative sense of control. Patients with good outcome exhibited the least negative modes of control and had the least desire for control. Typical and atypical patients showed similar but not identical control profiles. Conclusion: Healthier control was associated with better outcome of anorexia nervosa but their causal relationship was far from clear because of the cross-sectional nature of the present study. The Shapiro Control Inventory is a potentially useful instrument for studying control in eating disorders.

Fat phobic and non-fat phobic anorexia nervosa: a comparative study of 70 Chinese patients in Hong Kong

1993 ◽  
Vol 23 (4) ◽  
pp. 999-1017 ◽  
Author(s):  
S. Lee ◽  
T. P. Ho ◽  
L. K. G. Hsu
Keyword(s):  
Anorexia Nervosa ◽  
Hong Kong ◽  
Eating Disorder ◽  
Cross Cultural ◽  
Chinese Patients ◽  
Food Refusal ◽  
Careful Evaluation ◽  
Course Of Illness ◽  
Cross Cultural Study ◽  
Fat Phobia

SynopsisA mixed retrospective–prospective study of 70 Chinese anorexic patients in Hong Kong shows that although they were similar to Western anorexics in most other ways, 41 (58·6%) of them did not exhibit any fear of fatness throughout their course of illness. Instead, these non-fat phobic patients used epigastric bloating (31·4%), no appetite/hunger (15·7%) or simply eating less (12·9%) as legitimating rationales for food refusal and emaciation. Compared to fat phobic anorexics, they were significantly slimmer pre-morbidly (P< 0·0001) and were less likely to exhibit bulimia (P= 0·001). The possible explanations for the absence of fat phobia and the interpretive dilemma this provokes are discussed from historical, pathoplastic and cultural anthropological perspectives. It is argued that anorexia nervosa may display phenomenological plurality in a Westernizing society, and its identity may be conceptualized without invoking the explanatory construct of fat phobia exclusively. As non-fat phobic anorexia nervosa displays no culturally peculiar features, it is not strictly speaking a Western culture-bound syndrome, but may evolve into its contemporary fat phobic vogue under the permeative impact of Westernization. Its careful evaluation may help clarify the aetiology and historical transformation of eating disorder, foster the development of a cross-culturally valid taxonomy of morbid states of self-starvation, and exemplify some of the crucial issues that need to be tackled in the cross-cultural study of mental disorders.

Interpersonal Stress and Poor Health

2010 ◽  
Vol 15 (1) ◽  
pp. 3-11 ◽  
Author(s):  
Mette M. Aanes ◽  
Maurice B. Mittelmark ◽  
Jørn Hetland
Keyword(s):  
Psychological Distress ◽  
Depressive Symptoms ◽  
Social Relationships ◽  
Indirect Effects ◽  
Social Connectedness ◽  
Somatic Symptoms ◽  
Total Effect ◽  
Subjective Feeling ◽  
Interpersonal Stress ◽  
The Relationship

This paper investigated whether the lack of social connectedness, as measured by the subjective feeling of loneliness, mediates the well-known relationship between interpersonal stress and psychological distress. Furthermore, a relationship between interpersonal stress and somatic symptoms was hypothesized. The study sample included 3,268 women and 3,220 men in Western Norway. The main findings were that interpersonal stress was significantly related to psychological distress as well as to somatic symptoms, both directly and indirectly via paths mediated by loneliness. The size of the indirect effects varied, suggesting that the importance of loneliness as a possible mediator differs for depressive symptoms, anxiety symptoms, and somatic symptoms. In the case of depressive symptoms, more than 75% of the total effect was mediated through loneliness, while in the case of somatic symptoms just over 40% of the total effect was mediated through loneliness. This study supports the hypotheses that social connectedness mediates a relationship between interpersonal stress and psychological distress. The study also provides the first link between interpersonal stress, as measured by the Bergen Social Relationships Scale, and somatic symptoms, extending earlier research on the relationship between interpersonal stress and psychological distress.

The relationship between brain structure and general psychopathology in preadolescents

2020 ◽  
Author(s):  
Louise Mewton ◽  
Briana Lees ◽  
Lindsay Squeglia ◽  
Miriam K. Forbes ◽  
Matthew Sunderland ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Surface Area ◽  
Brain Structure ◽  
Parental Education ◽  
Mental Illnesses ◽  
General Psychopathology ◽  
Control Approach ◽  
Cortical Volume ◽  
Subcortical Regions ◽  
The Relationship

Categorical mental disorders are being recognized as suboptimal targets in clinical neuroscience due to poor reliability as well as high rates of heterogeneity within, and comorbidity between, mental disorders. As an alternative to the case-control approach, recent studies have focused on the relationship between neurobiology and latent dimensions of psychopathology. The current study aimed to investigate the relationship between brain structure and psychopathology in the critical preadolescent period when psychopathology is emerging. This study included baseline data from the Adolescent Brain and Cognitive Development (ABCD) Study® (n = 11,721; age range = 9-10 years; male = 52.2%). General psychopathology, externalizing, internalizing, and thought disorder dimensions were based on a higher-order model of psychopathology and estimated using Bayesian plausible values. Outcome variables included global and regional cortical volume, thickness, and surface area. Higher levels of psychopathology across all dimensions were associated with lower volume and surface area globally, as well as widespread and pervasive alterations across the majority of cortical and subcortical regions studied, after adjusting for sex, race/ethnicity, and parental education. The relationships between general psychopathology and brain structure were attenuated when adjusting for cognitive functioning. There was evidence of a relationship between externalizing psychopathology and frontal regions of the cortex that was independent of general psychopathology. The current study identified lower cortical volume and surface area as transdiagnostic biomarkers for general psychopathology in preadolescence. The widespread and pervasive relationships between general psychopathology and brain structure may reflect cognitive dysfunction that is a feature across a range of mental illnesses.

The New Progressive Dilemma through the Lens of Comparative Welfare State and Party Research

2018 ◽  
Author(s):  
Dennis C. Spies
Keyword(s):  
Public Opinion ◽  
Political Parties ◽  
Welfare State ◽  
Voting Behavior ◽  
Attitudinal Change ◽  
Welfare Institutions ◽  
The Us ◽  
Social Expenditures ◽  
The Relationship ◽  
Cross National

The chapter summarizes the New Progressive Dilemma (NPD) debate, identifying three arguments from comparative welfare state and party research likely to be relevant to the relationship between immigration and welfare state retrenchment: public opinion, welfare institutions, and political parties. Alignment of anti-immigrant sentiments and welfare support varies considerably between countries, especially between the US and Europe, leading to different party incentives vis-à-vis welfare state retrenchment. The chapter introduces insights from comparative welfare state and party research to the debate, discussing inter alia, political parties in terms of welfare retrenchment, immigrants as a voter group, and cross-national variation of existing welfare institutions. It addresses the complex debates around attitudinal change caused by immigration, levels of welfare support, voting behavior, and social expenditures. Combining these strands of literature, a common theoretical framework is developed that is subsequently applied to both the US and Western European context.

Self-Report Depression Scales in the Elderly: The Relationship between the CES-D and ZUNG

1989 ◽  
Vol 18 (4) ◽  
pp. 325-338 ◽  
Author(s):  
Bruce R. Deforge ◽  
Jeffery Sobal
Keyword(s):  
Mental Health ◽  
Sex Differences ◽  
Mental Health Problems ◽  
Psychological Symptoms ◽  
Somatic Symptoms ◽  
The Elderly ◽  
Self Report ◽  
Common Mental Health Problems ◽  
Depression Scales ◽  
The Relationship

Depression is one of the most common mental health problems in the elderly, but there is little consensus about the best way to assess depression in the aged. The relationship between the CES-D and the ZUNG self-report depression scales was investigated in seventy-eight elderly people with osteoarthritis (mean age 71). The correlation between the scales was r = .69, with the CES-D classifying 15 percent of the participants as depressed, as compared to 6 percent by the ZUNG. Psychological symptoms had the strongest relationship with overall depression scores on both scales. No sex differences were found on psychological items on either scale, but females reported more somatic symptoms on the ZUNG. People over age seventy-four reported more psychological symptoms than their younger counterparts.

The Conundrum of Reform: A Comparative Analysis

1988 ◽  
Vol 8 (3) ◽  
pp. 3-16 ◽  
Author(s):  
Patricia W. Ingraham ◽  
B. Guy Peters
Keyword(s):  
Cultural Differences ◽  
Policy Design ◽  
The United States ◽  
Civil Service Reform ◽  
Political Processes ◽  
Design Considerations ◽  
The United Kingdom ◽  
Procedural Reform ◽  
The Relationship ◽  
Cross National

Despite obvious cross-national political and cultural differences, civil service reform policies exhibit strong similarities. An examination of reform efforts in the United States, the United Kingdom and Australia emphasizes the centrality of politics and political processes to administrative reform. This is true for mechanical or procedural reform, structural reform and what we termed “relational reforms,” or, reforms aimed at restructuring the relationship between politicians and career civil servants. The overriding influence of politics reduces policy design considerations and often results in solutions that do not match the problems being addressed. The outcomes are new bureaucratic problems and the need for additional reforms.

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